Quality use of medicines: The young 'pill’ user with poor cycle control

Abstract

This review - the last in the present "Quality Use of Medicine" series - will again seek to demonstrate the applicability of the P-drug process in making a rational medicines choice in a typical family practice case. The patient in this instance is a woman in her early twenties, seeking contraceptive advice. Although she has been using a combined oral contraceptive (for argument's sake, Mercilon) for six months, she now indicates that she "would like to try something new". She mentions that she has read that monthly bleeding can be avoided by extending the traditional 21-day pill taking interval and would like to know more about this. A friend has recommended a new pill called "Yasmin", because she has heard it can help a woman lose weight. After careful probing she reveals that the actual reason for her visit is that she has experienced frequent breakthrough bleeding, which she describes as making her feel as though she is "bleeding more often than not". This has led to dissatisfaction with her contraceptive and her search for a method which will help her escape the nuisance of poor cycle control. First, though, a quick aside strictly speaking what she is swallowing is a tablet (made by compressing granules),not a pill (rolled and then cut), but the literature on the "Pill" generally refers to "pill-taking", so that convention will be retained.